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Alcohol Addiction: Treatment and Rehab

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Drinking alcohol is a common and often problematic occurrence throughout the United States, where approximately 17 million people were classified as heavy drinkers in 2020.1 In that same year, more then 28 million people in the U.S., ages 12 and older, met the criteria for an alcohol use disorder.1 If you find yourself among those who have been struggling with your drinking, you may be considering finding help through an alcohol rehab program.

You may have lots of questions, such as where to start or what will happen in alcohol rehab. Here, we will help you understand what an alcohol use disorder is, some of its causes, and how it is treated. The importance of alcohol rehab programs in managing alcohol withdrawal will also be discussed, along with treatment settings and discussions of the cost of an alcohol rehab center.


What is Alcohol Addiction?

Alcohol use disorder is a complicated medical issue that involves compulsive or otherwise problematic patterns of drinking, despite the negative outcomes associated with such use.2, 3 Addictions to various types of substances, including those involving alcohol, are diagnosed as substance use disorders (SUD). Different types of SUD may be diagnosed according to the specific substance involved, such as an alcohol use disorder, opioid use disorder, or cannabis use disorder.4 The diagnosis of an alcohol use disorder, like any SUD, can be further specified as mild, moderate, or severe, based on the number of diagnostic criteria that are met within a 12-month period.3


Causes of Alcohol Addiction

The causes of alcohol use disorders are complex, may not be the same for any two people. Whether or not any given individual may develop alcohol addiction most likely involves an interplay between genes and various other factors that include:2, 5

  • Family history of alcohol use disorder.
  • Parental drinking behavior.
  • Drinking begins at an early age.
  • History of childhood trauma.
  • The presence of certain mental health conditions, such as ADHD, depression, PTSD, schizophrenia, and personality disorders are all associated with an increased risk of alcohol use disorders.

How is Alcohol Addiction Treated?

Treatment for alcohol use disorder may incorporate several approaches. However, when thinking of how to begin the process, some of the first steps you can take include:6

  • Talking to your doctor, who can evaluate your general health, assess your drinking patterns, and discuss appropriate treatment options.
  • Doing research on your own to look for alcohol rehab programs, such as reading online reviews or looking through treatment directories.
  • Seeing if the program tailors treatment to the specific needs of the patient.
  • Seeing if the program has a wide variety of treatment approaches, including detox, medications, and behavioral therapy.
  • Asking questions about what the program expects of the patients as active participants in their own recovery.
  • Asking how each program addresses relapses.
  • Seeing which inpatient and outpatient treatment options may be covered by your insurance.

Once you have researched, asked questions, and selected an alcohol rehab program, you may wonder what happens next. Though treatment experiences vary, alcohol rehabilitation commonly includes:7

  • A thorough evaluation and intake assessment to determine the level of care needed. This should cover your alcohol use, medical, and social history. From this, your provider should develop a treatment plan based on your needs at the time of admission.
  • A period of supervised detox to help keep you safe and comfortable with medical withdrawal management, when needed.
  • Round-the-clock care in an inpatient or residential setting for relatively intensive treatment needs.
  • In some cases, an outpatient program may be an appropriate level of care to initiate treatment for AUD. Others might step down to an outpatient program after first completing an inpatient or residential treatment program.
  • Aftercare planning, which can include ongoing participation with a 12-Step program or other mutual support group.

What is Medical Detoxification?

Detoxification, or detox, is an important first step of the recovery process for many people with alcohol use disorders. Close patient monitoring and other medical detox interventions may be important due to the risk of certain severe withdrawal symptoms or withdrawal complications when a person stops drinking.8 When withdrawal risks are significant, a person undergoing detox from alcohol may be given medications, such as benzodiazepines, to help prevent seizures and manage other symptoms.8 In the case of acute alcohol withdrawal management, medical detox can save lives; however, it is important to note that detox is not a substitute for more comprehensive rehab efforts. Instead, detox can help to keep people stable in withdrawal while preparing them for the additional treatment work essential for long-term recovery.8


Understanding Alcohol Withdrawal

Alcohol withdrawal is a potentially serious concern for individuals with significantly severe levels of alcohol dependence.8 When a person drinks regularly, his or her body can become dependent upon it, meaning the body may become so adapted to the presence of alcohol, it essentially “requires” it to feel normal.9

Once you are dependent on alcohol and stop using it suddenly, you may be at risk for experiencing alcohol withdrawal, a syndrome that can include certain severe, and even life-threatening symptoms, in some cases. Therefore, when an individual with significant alcohol dependence stops drinking, close monitoring and pharmaceutical withdrawal management under the guidance of a medical professional may be necessary to keep people safe.9

Alcohol Withdrawal Symptoms

While alcohol withdrawal symptoms vary from one person to another, they often begin within 6 to 24 hours after a person stops using alcohol. Relatively mild cases of alcohol withdrawal may include symptoms such as:8

  • Anxiety.
  • Irritability.
  • Insomnia.
  • Reduced appetite.

However, some individuals may experience more severe alcohol withdrawal that includes the above symptoms, in addition to:8

  • Tremors.
  • Fever.
  • Sweating.
  • Nausea.
  • Elevated blood pressure.
  • Fast pulse.
  • Hypersensitivity to light and/or sound.
  • Auditory and/or visual hallucinations.
  • Seizures.

Progressively severe alcohol withdrawal sometimes manifests as the DTs, or delirium tremens, a potentially fatal condition marked by severe autonomic nervous system hyperactivity and profound disorientation and confusion.8, 9


Types of Alcohol Rehab Programs

There are numerous forms of treatment for alcohol use disorders. In most cases, there is no one standard or set treatment for everyone. Ideally, any treatment plan will be individualized for each person, based on his or her specific needs.6 Most people with AUD will improve with some form of treatment. Research suggests that roughly one third of people who receive treatment for an alcohol problem will be symptom-free one year later, with many others significantly reducing their drinking and experiencing fewer alcohol-related issues.6

Treatment settings can include both inpatient alcohol rehab and outpatient programs. Whether inpatient or outpatient, treatment can include behavioral therapies combined with medication, in some cases. Many programs emphasize a group therapy treatment approach, though individual counseling/therapy may also be an option. People with any co-occurring mental health issues benefit from an integrated treatment approach that addresses both their alcohol use disorder and their mental health disorder.6

What Is an Inpatient/Residential Alcohol Rehab Center?

Treatment for an alcohol use disorder at an inpatient or residential alcohol rehab center provides the opportunity to be treated in a closely supervised environment with 24/7 oversight and support. Not everyone needs a 24/7 inpatient program. However, an inpatient treatment program might be a particularly good fit for some people, including those with:7, 8

  • Co-occurring mental health disorders, like depression.
  • Other medical conditions, such as diabetes, that might need to be closely monitored during withdrawal.
  • A need for a detox from alcohol and withdrawal management to minimize the risk of side effects such as seizures.
  • An environment that is not conducive to recovery, with limited or no family support.
  • Serious substance use disorders, and who have been unable to get and stay drug free in other treatment programs.
  • A history of having seizures and other related complications during prior episodes of alcohol withdrawal.

A thorough assessment by a healthcare professional can help with treatment placement decisions, as they may be best able to determine the most appropriate level of care for a variety of patient circumstances.

What is an Outpatient Alcohol Rehab Center?

In an outpatient alcohol rehab center, you may encounter a similar range of behavioral and medication treatment approaches as found in inpatient or residential settings. However, with outpatient treatment programs, you are allowed to leave and sleep in your own home. Sometimes, you can still go to work and/or school. Examples of the different levels of care available in outpatient treatment settings include:

  • Partial hospitalization, the most intensive level of outpatient care, where you participate in treatment for around 20 hours per week.10
  • Intensive outpatient, where you attend treatment at least nine hours per week, sometimes after stepping down from inpatient treatment, or a partial hospitalization program.10
  • Individual therapy, which may take place two to three times per week in a therapist office or other outpatient clinical setting. Ongoing counseling sessions can help people with abstinence maintenance and relapse prevention as well as address other areas of potentially impaired functioning such as employment and family issues.11

How Long Does Alcohol Addiction Treatment Last?

The length of treatment at an alcohol rehab program varies from one person to another, based on many factors that include:

  • Severity of the alcohol use disorder.
  • Prior alcohol treatment episodes.
  • Overall physical health.
  • Co-occurring mental health disorders.

Many alcohol rehab programs advertise 30-, 60-, or 90-day programs. However, your treatment timeline will be based on your specific needs and recovery progress and can be adjusted as necessary.12


Types of Therapy for Alcohol Addiction

There are various behavioral therapy approaches that may be used to help treat alcohol use disorders. These are often used in combination with other types of treatment, such as medication. Some commonly used approaches are:12, 13

  • Cognitive-behavioral therapy, which is also called CBT. CBT is used in many programs, and can help you change maladaptive patterns of thought, find new ways to cope with stress that don’t involve drinking, or manage triggers that can lead to relapse.
  • Contingency management, which uses various types of incentives or rewards for achieving treatment goals. For example, if a person attends a specified number of AA meetings, he or she may be given vouchers for items like movie tickets or basic necessities.
  • Motivational interviewing, which is an approach that can help people resolve any lingering ambivalence about seeking treatment or engaging with their treatment plan.

Types of Medications Used for Treatment

In addition to behavioral therapy for treating an alcohol use disorder, medication can also be an important component of treatment. The medications most frequently used to treat alcohol use disorders are:12, 14

  • Acamprosate, which can help minimize drinking behavior and relapse risks by reducing some of the relatively protracted or long-term withdrawal symptoms, such as anxiety, depression, and insomnia. It may be more helpful for those with a severe alcohol use disorder.
  • Naltrexone, which is a medication that was originally developed to treat opioid dependence but is also effective in treating alcohol use disorders. Naltrexone helps a person remain abstinent by blocking some of the inherent reward associated with drinking alcohol.
  • Disulfiram, which causes flushing, vomiting, nausea, and trouble breathing if a person ingests alcohol while on it. The aversion to experiencing these effects is what helps people who take disulfiram avoid the use of alcohol.

Recovery Support Groups

A recovery support group can be an important component of a person’s recovery from an alcohol use disorder to help them continue the positive, healthy behaviors learned in treatment. Mutual support groups have been shown to increase abstinence from alcohol use for many people.15 Many treatment programs introduce participants to the concepts of the 12-Step meeting model and encourage attendance after discharge.16 The best known of the 12-Step programs is Alcoholics Anonymous, or AA. AA is free, and the only requirement to participate is a desire to quit drinking.17


How Much Does Alcohol Rehab Cost?

The cost of treatment at an alcohol rehab facility will vary based on multiple factors, such as:

  • The length of treatment.
  • Type of program, such as inpatient or outpatient.
  • The amenities, such as private rooms or gourmet meals.

Whatever the cost of an alcohol treatment program, there are numerous ways to pay for treatment that include:

  • Health insurance.
  • Publicly funded programs that may take Medicare or Medicaid.
  • Programs that offer sliding-scale fees based on income.
  • Treatment facilities that offer payment plans.
  • Loans from a bank, or even friends and family.

If you have health insurance, it can be reassuring to note that under the Affordable Care Act, or ACA, mental health and SUD treatment are considered essential benefits, and health insurance plans must offer some type of coverage for treating these disorders.18 You can verify your insurance to see if your coverage and benefits can help pay for your alcohol rehab treatment.


Find an Alcohol Rehab Program Near You

If you are searching for detoxification centers, inpatient treatment, or outpatient treatment, AAC offers various rehab centers across the United States.

If you have questions about drug and alcohol abuse treatment programs, help is just a phone call away. Contact our 24-hour helpline, toll-free at 1-888-744-0069 for confidential and professional assistance or complete our quick form for alcohol abuse treatment help.

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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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